Provider Demographics
NPI:1881930253
Name:ARLINGTON PEDIATRIC CENTER
Entity type:Organization
Organization Name:ARLINGTON PEDIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GONZALO
Authorized Official - Middle Name:
Authorized Official - Last Name:PAZ-SOLDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-271-8109
Mailing Address - Street 1:601 S CARLIN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1044
Mailing Address - Country:US
Mailing Address - Phone:703-271-8800
Mailing Address - Fax:
Practice Address - Street 1:601 S CARLIN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1044
Practice Address - Country:US
Practice Address - Phone:703-271-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904001756261Q00000X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center